Ecology and Management of a Large Outbreak of Avian Botulism in Wild Waterbirds in Northeastern Italy (2019-2022).

Avian botulism is a paralytic disease due to the ingestion of botulinum neurotoxins (BoNT) produced by anaerobic, sporigenic bacteria (notably, Clostridium botulinum). Wild waterbirds worldwide are affected with variable recurrence and severity, and organic material decaying in wetland habitats may constitute a suitable substrate for the replication of clostridia strains producing BoNT in conditions of high temperatures and the absence of oxygen. Here, we describe a large outbreak of avian botulism that occurred in the Valle Mandriole protected area of northeastern Italy (VM). After the recovery in late summer of a few duck carcasses that molecularly tested positive for BoNT-producing clostridia, in October 2019, the avian botulism escalation led to a total of 2367 birds being recovered (2158 carcasses and 209 sick birds). Among these, 2365/2367 were waterbirds, with ducks accounting for 91.8% of the total (2173/2367) and green-winged teals representing 93.5% of the ducks. After the quick collection of dead and sick birds (from 4 to 11 October 2019) and the flooding of the VM wetland (from 5 to 12 October 2019), the 2019 botulism emergency apparently ended. Following two water inputs in May and July 2020, only one pooled sample obtained from 16 bird carcasses found that year in VM tested positive for clostridia type C by real-time PCR, whereas, after to the implementation of measures deterring the bird's presence, new avian botulism cases-due to clostridia type C and C/D, according to molecular and animal-model tests of confirmation-led to the collection of 176 waterbirds (82 carcasses and 94 sick ducks) and 16 waterbirds (9 carcasses and 7 sick ducks) in the summers 2021 and 2022, respectively. In conclusion, the prevention, management, and control of the disease rely on habitat management, the quick and careful collection/removal of animal carcasses, and the regular monitoring and surveillance of live and dead birds.

Psychosocial Well-Being Differences Between the Young Old, Old-Old, and Oldest Old: A Global Comparison.

OBJECTIVES: We investigate global differences in psychosocial well-being between older adult age groups. METHODS: Using multinomial logistic regression, we analyzed 2018 data (n = 93,663) from 9 countries/regions in the Health and Retirement Study international family of studies to compare age group differences in depression, loneliness, and happiness. RESULTS: Compared to the young old, the old-old reported more depression in Southern Europe, while the oldest old had higher risk in India and Southern Europe but lower risk in the United States. The old-old reported less loneliness in the United States but more in Southern Europe, while the oldest old had greater risk in Southern Europe. The old-old reported less happiness in Korea, while the oldest old had lower reports in Korea but higher reports in the United States. DISCUSSION: The psychosocial well-being of the oldest old is exceptionally good in the United States but exceptionally poor in Southern Europe.

Activity of ceftolozane/tazobactam and imipenem/relebactam against clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected in Greece and Italy-SMART 2017-2021.

PURPOSE: The current study evaluated the in vitro activities of ceftolozane/tazobactam (C/T), imipenem/relebactam (IMI/REL), and comparators against recent (2017-2021) clinical isolates of gram-negative bacilli from two countries in southern Europe. METHODS: Nine clinical laboratories (two in Greece; seven in Italy) each collected up to 250 consecutive gram-negative isolates per year from lower respiratory tract, intraabdominal, urinary tract, and bloodstream infection samples. MICs were determined by the CLSI broth microdilution method and interpreted using 2022 EUCAST breakpoints. ß-lactamase genes were identified in select ß-lactam-nonsusceptible isolate subsets. RESULTS: C/T inhibited the growth of 85-87% of Enterobacterales and 94-96% of ESBL-positive non-CRE NME (non-Morganellaceae Enterobacterales) isolates from both countries. IMI/REL inhibited 95-98% of NME, 100% of ESBL-positive non-CRE NME, and 98-99% of KPC-positive NME isolates from both countries. Country-specific differences in percent susceptible values for C/T, IMI/REL, meropenem, piperacillin/tazobactam, levofloxacin, and amikacin were more pronounced for Pseudomonas aeruginosa than Enterobacterales. C/T and IMI/REL both inhibited 84% of P. aeruginosa isolates from Greece and 91-92% of isolates from Italy. MBL rates were estimated as 4% of Enterobacterales and 10% of P. aeruginosa isolates from Greece compared to 1% of Enterobacterales and 3% of P. aeruginosa isolates from Italy. KPC rates among Enterobacterales isolates were similar in both countries (7-8%). OXA-48-like enzymes were only identified in Enterobacterales isolates from Italy (1%) while GES carbapenemase genes were only identified in P. aeruginosa isolates from Italy (2%). CONCLUSION: We conclude that C/T and IMI/REL may provide viable treatment options for many patients from Greece and Italy.

Leaving the parental home during the COVID-19 pandemic: the case of Southern Europe.

In 2020, COVID-19-related governmental restrictions forced individuals to radically change their habits, possibly impacting on their living arrangements. Whether COVID-19 affected young adults' propensity to leave the parental home is still unknown; Southern Europe is of particular interest, as youth experience the "latest-late" transition to adulthood, face uncertainty in the labor market, and receive low welfare support. Using EU-SILC longitudinal data from Greece, Spain, Italy, and Portugal, this study examines how home-leaving rates evolved in the short-term and explores the relationship between governmental restrictions, economic characteristics of households and young adults, and leaving home behaviors. Descriptive analyses reveal that the share of young adults leaving the parental home in Southern Europe between 2019 and 2020 slightly increased compared to previous years. Discrete-time event history models show that the propensity to leave the parental home increases with the stringency of policy measures. Young adults with the highest likelihood to leave home are employed individuals whose households are in the lowest income quintile as well as students from the highest income quintile, suggesting that, in these countries, residential independence is associated with either the acquisition of economic resources in the labor market or the availability of family resources. We interpret this result in favor of an "independence effect" exerted by COVID-19-related restrictions on young adults; future research might establish whether this trend is temporary or persistent over time.

The impact of under-investment on health in Southern and Central Eastern European Countries.

INTRODUCTION: Better health improves human capital and is a driver to economic growth. The allocation of resources to national health systems should be prioritized as investment and not expense/cost. AREAS COVERED: The purpose of this paper is to investigate the impact of Underinvestment on Medicines and Health in the Southern and Central Eastern European Countries. Two main databases were used for the purpose of this paper. Time series macro data covering the period 1960-2021, and micro data from SHARE survey for 322,724 individuals aged 50 and over from the European Countries. EXPERT OPINION: Evidence across the Southern and Central Eastern Èuropean Member States reveals the significant underinvestment in health and medicines and the need for policy intervention to improve access and health outcomes. Further reductions in healthcare budgets would increase unmet needs the prevalence of multimorbidity and the out-of-pocket burden on households leading to catastrophic payments for medicines and health-care services. Public health actions should be undertaken by the International Organizations and National Governments to bridge the gap in health investment, by improving access, tackling health inequalities, and reducing the burden of catastrophic payments.

Sexology, sexual development, and hormone treatments in Southern Europe and Latin America, c.1920-40.

Displacing the physiological model that had held sway in 19th-century medical thinking, early 20th-century medical scientists working on hormones promoted a new understanding of the body, psychological reactions, and the sexual instinct, arguing that each were fundamentally malleable. Hormones came to be understood as the chemical messengers that regulated an individual's growth and sexual development, and sexologists interested in this area focused primarily on children and adolescents. Hormone research also promoted a view of the body in which 'hermaphroditism', homosexuality, and 'sexual perversions' such as masochism and sadism were attributed to anomalies in the internal secretions produced by the testes or the ovaries. This article focuses on Spanish, Italian, Argentinian, and Brazilian sexology shaped by endocrinological research in the interwar period. First, it shows the key role hormone treatments played in the historical development of sexology in Southern Europe and Latin America. Second, it looks at how sexologists employed hormone research to study human sexual development in the early stages of life, and how they set about 'correcting' what they viewed as 'sexual anomalies'.

Staff Members' Experience of Italian Shelters for LGBTQIA+ Homeless and Runaway People: An Exploratory Study.

BACKGROUND: Some LGBTQIA+ people, after coming out, experience marginalization and homelessness due to rejection and discrimination from their family and community. The increase in support requests led to the creation of LGBTQIA+ temporary shelter homes worldwide. This study aims to explore the functioning and effectiveness of shelters, analyzing the experiences of staff members in Italy. METHODS: Focus groups were held with a total of 15 staff members (age range: 32-53) working in three shelters for LGBTQIA+ people. Data were analyzed qualitatively through the grounded theory methodology. RESULTS: Data coding showed five final core categories: (1) user characteristics; (2) staff characteristics; (3) community relations; (4) activities carried out by services; (5) criteria for intervention assessment and staff satisfaction. Results revealed some criticalities in the effectiveness of these services, particularly the difficulty in achieving autonomy for users, a weakness attributable to the non-exhaustive training of staff members and the funding discontinuity. CONCLUSION: To improve the efficacy of shelters, this study emphasizes the necessity to (a) carry out an analysis of the vulnerability of the local LGBTQIA+ community, (b) establish a stable network with local services (NHS system), and (c) implement staff members' psychological training.

Health and fitness trends in Southern Europe for 2023: A cross-sectional survey.

The physical activity, exercise and wellness sector is rapidly growing and seems to be an exciting field for business and professional development with great potential globally. The purpose of this observational and cross-sectional study was to determine the most popular health and fitness trends in Southern Europe for the first time, including data from Italy, Spain, Portugal, Greece and Cyprus, and to investigate any potential differences in this area compared to the Pan-European and global fitness trends for 2023. A national online survey was conducted in five Southern European countries, using the methodology of similar regional and worldwide surveys conducted by the American College of Sports Medicine since 2007. In total, a web-based questionnaire was sent to 19,887 professionals who worked in the Southern European physical activity, exercise and wellness sector. A total of 2645 responses were collected from five national surveys with an overall mean response rate of 13.3%. The ten most important fitness trends in Southern Europe for 2023 were personal training, licensure for fitness professionals, exercise is medicine, employing certified fitness professionals, functional fitness training, small group training, high-intensity interval training, fitness programs for older adults, post-rehabilitation classes and body weight training. The present findings are aligned with those reported for the European and worldwide fitness trends.

Invasive meningococcal disease epidemiology and vaccination strategies in four Southern European countries: a review of the available data.

INTRODUCTION: Invasive meningococcal disease (IMD) is a major health concern which can be prevented through vaccination. Conjugate vaccines against serogroups A, C, W, and Y and two protein-based vaccines against serogroup B are currently available in the European Union. AREAS COVERED: We present epidemiologic data for Italy, Portugal, Greece, and Spain using publicly available reports from national reference laboratories and national or regional immunization programs (1999-2019), aiming to confirm risk groups, and describe time trends in overall incidence and serogroup distribution, as well as impact of immunization. Analysis of circulating MenB isolates in terms of the surface factor H binding protein (fHbp) using PubMLST is discussed as fHbp represents an important MenB vaccine antigen. Predictions of potential reactivity of the two available MenB vaccines (MenB-fHbp and 4CMenB) with circulating MenB isolates are also provided as assessed using the recently developed MenDeVAR tool. EXPERT OPINION: Understanding dynamics of IMD and continued genomic surveillance are essential for evaluating vaccine effectiveness, but also prompting proactive immunization programs to prevent future outbreaks. Importantly, the successful design of further effective meningococcal vaccines to fight IMD relies on considering the unpredictable epidemiology of the disease and combining lessons learnt from capsule polysaccharide vaccines and protein-based vaccines.

Did COVID-19 enlarge spatial disparities in population dynamics? A comparative, multivariate approach for Italy.

A short-term issue that has been occasionally investigated in the current literature is if (and, eventually, how) population dynamics (directly or indirectly) driven by COVID-19 pandemic have contributed to enlarge regional divides in specific demographic processes and dimensions. To verify this assumption, our study run an exploratory multivariate analysis of ten indicators representative of different demographic phenomena (fertility, mortality, nuptiality, internal and international migration) and the related population outcomes (natural balance, migration balance, total growth). We developed a descriptive analysis of the statistical distribution of the ten demographic indicators using eight metrics that assess formation (and consolidation) of spatial divides, controlling for shifts over time in both central tendency, dispersion, and distributional shape regimes. All indicators were made available over 20 years (2002-2021) at a relatively detailed spatial scale (107 NUTS-3 provinces) in Italy. COVID-19 pandemic exerted an impact on Italian population because of intrinsic (e.g. a particularly older population age structure compared with other advanced economies) and extrinsic (e.g. the early start of the pandemic spread compared with the neighboring European countries) factors. For such reasons, Italy may represent a sort of 'worst' demographic scenario for other countries affected by COVID-19 and the results of this empirical study can be informative when delineating policy measures (with both economic and social impact) able to mitigate the effect of pandemics on demographic balance and improve the adaptation capacity of local societies to future pandemic's crises.

A qualitative study with Italian patients exploring the spiritual dimension during a chronic disease.

BACKGROUND: Spirituality is a vast dimension influenced by cultural and personal differences. Little is known about the spirituality of patients suffering from a chronic disease in Italy from palliative care hospital settings. AIM: To investigate patients' perspectives about their spirituality during their illness. METHOD: The research question was: 'How does living with chronic disease inform/shape the spiritual dimension of patients?'. To address it, we conducted a qualitative interview study with thematic analysis. RESULTS: We enrolled 21 participants among patients suffering from rheumatic, haematologic, neurodegenerative and respiratory chronic diseases. Participants generally had great difficulty answering the questions researchers posed and often could not define 'spirituality'. We found different topics grouped under four main themes: definition of spirituality, internal dialogue, expression of spirituality in everyday life and take stock. Religion is not reported as an answer to spiritual suffering, even in a country that is felt religious-driven like Italy. DISCUSSION: Patients are generally not cognizant of this dimension even living with a chronic disease; consequently, they cannot express spiritual needs because they can't recognise them. Health professionals should identify this dimension and its characteristics to recognise potential spiritual suffering.

Epizootic Hemorrhagic Disease Virus Serotype 8, Italy, 2022.

We describe the detection of epizootic hemorrhagic disease virus (EHDV) serotype 8 in cattle farms in Sardinia and Sicily in October-November 2022. The virus has a direct origin in North Africa; its genome is identical (>99.9% nucleotide sequence identity) to EHDV serotype 8 strains detected in Tunisia in 2021.

Characterization of biophysical contexts leading to severe wildfires in Portugal and their environmental controls.

Characterizing the fire regime in regions prone to extreme wildfire behavior is essential for providing comprehensive insights on potential ecosystem response to fire disturbance in the context of global change. We aimed to disentangle the linkage between contemporary damage-related attributes of wildfires as shaped by the environmental controls of fire behavior across mainland Portugal. We selected large wildfires (≥100 ha, n = 292) that occurred during the 2015-2018 period, covering the full spectrum of large fire-size variation. Ward's hierarchical clustering on principal components was used to identify homogeneous wildfire contexts at landscape scale on the basis of fire size, proportion of high fire severity, and fire severity variability, and their bottom-up (pre-fire fuel type fraction, topography) and top-down (fire weather) controls. Piecewise Structural Equation Modeling was used to disentangle the direct and indirect relationships between fire characteristics and fire behavior drivers. Cluster analysis evidenced severe and large wildfires in the central region of Portugal displaying consistent fire severity patterns. Thus, we found a positive relationship between fire size and proportion of high fire severity, which was mediated by distinct fire behavior drivers involving direct and indirect pathways. A high fraction of conifer forest within wildfire perimeters and extreme fire weather were primarily responsible for those interactions. In the context of global change, our results suggest that pre-fire fuel management should be targeted at expanding the fire weather settings in which fire control is feasible and promote less flammable and more resilient forest types.

Oral Pathology in Portuguese Dogs: An Eight-Year Biopsy-Based Retrospective Study.

The oral cavity of the dog can be the site of several types of pathology including both benign and malignant lesions. The aim of this study was to analyze the frequency and clinical-pathological characteristics of oral lesions present in a cohort of Portuguese dogs. A retrospective observational cross-sectional study on 704 canine oral lesions submitted for histopathological diagnosis to a Veterinary Pathology Center in the north of Portugal from 2010 to 2017 was performed. Gender, age, location of the lesion and the histopathological diagnosis was analysed. From the 704 cases included, 307 (43.6%) were females and 397 (56.4%) males. The mean age was 9.53 ± 3.6 years-old (range 3 to 240 months). The site most frequently affected was the gingiva (n = 283; 40.2%). 342 (48.6%) cases were malignant neoplasms, most represented by oral melanoma (n = 129; 37.7%). 256 (36.4%) cases were benign neoplasms, most represented by fibromatous epulis of periodontal ligament origin/peripheral odontogenic fibroma (FEPLO/POF) (n = 208;81.3%). 106 (15%) were non-neoplastic lesions, most represented by gingival hyperplasia (n = 25, 23.6%). This study provides useful information about frequency and distribution of oral lesions in dogs over a period of eight years allowing valuable comparison with other countries and other species. The most common benign tumours were FEPLO/POF while oral melanoma was the most common malignant tumour.

Framing socioecological complexity: The long-term evolution of multiple dimensions of desertification risk in Italy.

Desertification risk depends on the interplay of biophysical and socioeconomic drivers, among which climate change, soil depletion, landscape modifications, and biodiversity decline are key factors of change in Southern Europe. The present study introduces a diachronic analysis of desertification risk in Italy adopting a multidimensional approach based on four dimensions (ecological, economic, demographic, and administrative) assessed at three dates (1961, 1991, and 2011). These risk components were evaluated separately in Southern Italy, a formerly affected region (sensu United Nations Convention to Combat Desertification), and Northern/Central Italy, a nonaffected region in the country. All risk measures document how the divide between affected and nonaffected regions in Italy has gradually reduced. Because of local warming and rising human pressure, Northern Italy has recently displayed a level of desertification risk close to those observed in Southern Italy over the last 30 years. These results suggest a thorough revision of the national classification of risky areas, that may inform more specific mitigation and adaptation policies responding effectively to recent socioenvironmental trends and local (economic) dynamics. The intrinsic system's evolution observed at both regional and national level in Italy may be generalized to a broader European context. Our work finally documents the appropriateness of a multidimensional definition of desertification risk grounded on the joint analysis of ecological, demographic, economic, and administrative indicators. A comprehensive knowledge of socioeconomic patterns and processes of change contributes to more precise scenario modeling and design of integrated strategies mitigating desertification risk.

Climate change effects on bread wheat phenology and grain quality: A case study in the north of Italy.

Increasing temperatures, heat waves, and reduction of annual precipitation are all the expressions of climate change (CC), strongly affecting bread wheat (Triticum aestivum L.) grain yield in Southern Europe. Being temperature the major driving force of plants' phenological development, these variations also have effects on wheat phenology, with possible consequences on grain quality, and gluten protein accumulation. Here, through a case study in the Bolognese Plain (North of Italy), we assessed the effects of CC in the area, the impacts on bread wheat phenological development, and the consequences on grain gluten quality. The increasing trend in mean annual air temperature in the area since 1952 was significant, with a breakpoint identified in 1989, rising from 12.7 to 14.1°C, accompanied by the signals of increasing aridity, i.e., increase in water table depth. Bread wheat phenological development was compared in two 15-year periods before and after the breakpoint, i.e., 1952-1966 (past period), and 2006-2020 (present period), the latest characterized by aridity and increased temperatures. A significant shortening of the chronological time necessary to reach the main phenological phases was observed for the present period compared to the past period, finally shortening the whole life cycle. This reduction, as well as the higher temperature regime, affected gluten accumulation during the grain-filling process, as emerged analyzing gluten composition in grain samples of the same variety harvested in the area both before and after the breakpoint in temperature. In particular, the proportion of gluten polymers (i.e., gliadins, high and low molecular weight glutenins, and their ratio) showed a strong and significant correlation with cumulative growing degree days (CGDDs) accumulated during the grain filling. Higher CGDD values during the period, typical of CC in Southern Europe, accounting for higher temperature and faster grain filling, correlated with gliadins, high molecular weight glutenins, and their proportion with low molecular weight glutenins. In summary, herein reported, data might contribute to assessing the effects of CC on wheat phenology and quality, representing a tool for both predictive purposes and decision supporting systems for farmers, as well as can guide future breeding choices for varietal innovation.

Drivers of phenological changes in southern Europe.

The life cycle of plants is largely determined by climate, which renders phenological responses to climate change a highly suitable bioindicator of climate change. Yet, it remains unclear, which are the key drivers of phenological patterns at certain life stages. Furthermore, the varying responses of species belonging to different plant functional types are not fully understood. In this study, the role of temperature and precipitation as environmental drivers of phenological changes in southern Europe is assessed. The trends of the phenophases leaf unfolding, flowering, fruiting, and senescence are quantified, and the corresponding main environmental drivers are identified. A clear trend towards an earlier onset of leaf unfolding, flowering, and fruiting is detected, while there is no clear pattern for senescence. In general, the advancement of leaf unfolding, flowering and fruiting is smaller for deciduous broadleaf trees in comparison to deciduous shrubs and crops. Many broadleaf trees are photoperiod-sensitive; therefore, their comparatively small phenological advancements are likely the effect of photoperiod counterbalancing the impact of increasing temperatures. While temperature is identified as the main driver of phenological changes, precipitation also plays a crucial role in determining the onset of leaf unfolding and flowering. Phenological phases advance under dry conditions, which can be linked to the lack of transpirational cooling leading to rising temperatures, which subsequently accelerate plant growth.

Low Adherence to the Mediterranean Diet Is Associated with Poor Socioeconomic Status and Younger Age: A Cross-Sectional Analysis of the EpiDoC Cohort.

The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns as it has been consistently associated with several beneficial health outcomes. Adherence to the MD pattern has been decreasing in southern European countries for the last decades, especially among low socioeconomic groups. The aim of this study was to assess the adherence to the MD in Portugal, to evaluate regional differences, and explore associated factors (sociodemographic, economic, and lifestyles behaviors). This study used the third data collection wave of the Epidemiology of Chronic Diseases Cohort Study (EpiDoC 3). MD adherence was assessed using the Portuguese-validated MD adherence score (MEDAS) questionnaire. Non-adjusted and adjusted logistic regression models were used to assess the risk factors for low MD adherence and individual MEDAS items. In this cross-sectional evaluation of the EpiDoC 3 cohort study (n = 5647), 28.8% of the Portuguese population had low adherence to a MD. Azores and Madeira had lower adherence to the MD than the rest of the country. Younger individuals in lower income categories (e.g., ORfinding it very difficult = 1.48; 95% CI 1.16-1.91) and with a lower educational level (e.g., OR0-4 years = 2.63; 95% CI 2.09-3.32) had higher odds of having a lower adherence to the MD. Portuguese adults have a high prevalence of low adherence to the MD, especially among those who are younger and have lower socioeconomic status. Public health policies to promote adherence to the MD should pay special attention to these groups.

Single-Parent Families, Educational Gradient, and Child Deprivation: The Cases of Italy and Spain.

This work examines whether the increase of single parenthood in Italy and Spain, specifically amongst women in an unfavourable socioeconomic position, has repercussions for child well-being, understood here as material deprivation. In particular, our main objective is to analyse the possible differential impact of single parenthood on children's material deprivation in relation to mothers' level of education. Using the 2014 EU-SILC Module on material deprivation, we identify five areas of child deprivation based on the EU-MODA approach: nutrition, clothing, education, leisure, and social life. In the case of Italy, our main results indicate that, compared to children from two-parent households, children of single mothers with a low level of education have a higher risk of nutrition and clothing deprivation. In Spain, living in a single-parent household is associated with a higher risk of deprivation in terms of social life for those children whose mothers do not have a high level of education. Therefore, the findings suggest that in both countries the growth of single parenthood amongst women with a lower educational level may have an impact on child well-being inequality. This article contributes empirical data to the growing literature on the rise of child poverty in Southern European countries.

Urbanisation-driven land degradation and socioeconomic challenges in peri-urban areas: Insights from Southern Europe.

Climate change and landscape transformation have led to rapid expansion of peri-urban areas globally, representing new 'laboratories' for the study of human-nature relationships aiming at land degradation management. This paper contributes to the debate on human-driven land degradation processes by highlighting how natural and socioeconomic forces trigger soil depletion and environmental degradation in peri-urban areas. The aim was to classify and synthesise the interactions of urbanisation-driven factors with direct or indirect, on-site or off-site, and short-term or century-scale impacts on land degradation, focussing on Southern Europe as a paradigmatic case to address this issue. Assuming complex and multifaceted interactions among influencing factors, a relevant contribution to land degradation was shown to derive from socioeconomic drivers, the most important of which were population growth and urban sprawl. Viewing peri-urban areas as socio-environmental systems adapting to intense socioeconomic transformations, these factors were identified as forming complex environmental 'syndromes' driven by urbanisation. Based on this classification, we suggested three key measures to support future land management in Southern European peri-urban areas.